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OBJECTIVE: Treatment of extensive chronic venous obstruction (CVO) with post-thrombotic trabeculation involving the common femoral vein with extension into the femoral vein or deep femoral vein remains a challenge and the best treatment technique for such cases is not clear. In the present study, we compared the results of endovascular alone vs endovascular with additional endophlebectomy (hybrid) procedures for such patients.METHODS: The medical records of 102 consecutive patients (108 limbs) treated between 2015 and 2020 for iliofemoral CVO extending to the femoral confluence were retrospectively reviewed. The patients were divided into two groups: the hybrid procedure (HP) and endovascular treatment (EN) groups. The HP group consisted of those treated with stent implantation and endophlebectomy of the common femoral vein with creation of an arteriovenous fistula. The EN group included those who had undergone stent implantation alone. The patency rates, complications, and clinical outcomes were analyzed.RESULTS: Of the 102 patients, 47 (49 limbs) were in the EN group and 55 (59 limbs) were in the HP group. The demographics of the two groups were similar with no statistically significant differences in cumulative primary, assisted primary, or secondary patency rates at 36 months (33.7% vs 36.3%, P = .839; 59.8% vs 64%, P = .941; 69% vs 72.7%, P = .851; respectively). The patients in the EN group, however, had better clinical improvement with a lower postoperative complication rate (P = .012), shorter procedure duration (P < .001), and shorter hospital stay (P = .025).CONCLUSIONS: The EN and HP both provided similar patency rates for patients with CVO extending into the femoral confluence. The endovascular strategy has the benefit of fewer postoperative complications and a shorter procedure duration and hospital stay compared with the HP.

The research was carried out in order to synthesize CuNPs which use extract of green tea, then characterize them and investigate its antibacterial only or in combination with Ciprofloxacin for the treatment of S. aureus. Then, use a blood test to verify its efficacy in healing wounds infected with S. aureus in laboratory Hamsters. The results showed that green tea was successful in converting copper nitrate to CuNPs, as evidenced by the ultraviolet spectrum, which showed an absorbance at 271 nm. CuNPs with a size range of 5–65 nm and an average size of 5–20 nm were found to have a spherical form. CuNPs had a 20% antibacterial and a synergistic effect when mixed with Ciprofloxacin against S. aureus. It appeared that the CuNPs or ciprofloxacin, alone or in combination, had synergistic effects in healing the infected wounds in a shorter length of time than the control group of treatment in the biological study. The use of S. aureus to heal induced wounds resulted in significantly higher WBCs and lower platelet counts, whereas the treatment with CuNPs or Ciprofloxacin, alone or in combination, resulted in WBCs and platelet counts that were referred within normal ranges and did not differ from the control group. Furthermore, appeared non differences in Hb, RBCs, or PCV, urea, creatinine as well as the levels of IgG, IgA antibody and the liver enzyme of GOT and GPT across all treatment groups compared with the values in infection animal groups.

Objective The impact of stent design on venous patency is not well studied. The purpose of this study was to investigate the effect of stent material burden on endothelial coverage of stented venous segments, which may contribute to vessel healing and patency. Methods Segmented self expanding bare nitinol stents (18 × 50 mm) comprising 5 mm long attached metallic rings separated by 2, 5, or 8 mm gaps were implanted in the inferior vena cava (IVC) of 10 sheep. These stents were designed and manufactured for the purposes of this study. At six, 12, and 24 weeks after implantation the animals were euthanised and the stented vessels harvested for histomorphometric analysis. Three sections from the metallic part as well as the gaps between the struts were reviewed for quantification of endothelialisation after six, 12, and 24 weeks. The intimal thickness over and between the stent struts was measured. The endothelialisation score (graded from 1 for complete luminal endothelialisation to 5 for absence of endothelial cells) was determined. Results All stents were successfully deployed and all 10 sheep survived until the time of harvesting. Macroscopic inspection after 24 weeks showed only partial endothelialisation over stents with 2 mm and 5 mm skipped segments, whereas the stents with 8 mm skipped segments were totally incorporated into the vein wall. After 24 weeks, the mean (SD) neointimal thicknesses over stent struts with 2 mm, 5 mm, and 8 mm skipped segments were 254.0 (51.6), 182.2 (98.1), and 194.6 (101.1) μm, respectively. Comparison of endothelialisation scores of stents over time showed statistically significantly better endothelialisation over stents with 8 mm gaps after 12 and 24 weeks. Conclusion Stent designs providing structural support to veins with larger gaps between the scaffold material appear to lead to faster and more complete endothelialisation as well as a thinner intimal layer.

Purpose To evaluate the feasibility of a new optical device that measures peripheral blood flow as a diagnostic and monitoring tool for patients with peripheral artery disease (PAD). Materials and Methods In this prospective study, 167 limbs of 90 patients (mean age, 76 y; 53% men) with suspected PAD were evaluated with the FlowMet device, which uses a new type of dynamic light-scattering technology to assess blood flow in real time. Measurements of magnitude and phasicity of blood flow were combined into a single-value flow–waveform score and compared vs ankle–brachial index (ABI), toe–brachial index (TBI), and clinical presentation of patients per Rutherford category (RC). Receiver operating characteristic curves were constructed to predict RC. Area under the curve (AUC), sensitivity, and specificity were compared among flow–waveform score, ABI, and TBI. Results Qualitatively, the FlowMet waveforms were analogous to Doppler velocity measurements, and degradation of waveform phasicity and amplitude were observed with increasing PAD severity. Quantitatively, the flow, waveform, and composite flow–waveform scores decreased significantly with decreasing TBI. In predicting RC ≥ 4, the flow–waveform score (AUC = 0.83) showed a linear decrease with worsening patient symptoms and power comparable to that of TBI (AUC = 0.82) and better than that of ABI (AUC = 0.71). Optimal sensitivity and specificity pairs were found to be 56%/83%, 72%/81%, and 89%/74% for ABI, TBI, and flow–waveform score, respectively. Conclusions The technology tested in this pilot study showed a high predictive value for diagnosis of critical limb ischemia. The device showed promise as a diagnostic tool capable of providing clinical feedback in real time.

Distribution of light intensity in the flat photobioreactor for microalgae cultivation as a step design for production of bio-renewable energy was addressed in the current study. Five sizes of bioreactors with specific distances from the main light source were adopted as independent variables in experiential design model. The results showed that the bioreactor’s location according to the light source, determines the nature of light intensity distribution in the reactor body. However, the cross-section area plays an important role in determining the suitable location of reactor to achieve required light homogeneity. This area could change even the expected response of the light passing through the reactor if Beer-Lambert's law is adopted. In addition, the increase in path length of light inside the bioreactor reduces the amount absorbed by the liquid per unit volume. Finally, the study concluded that these factors represent a basic pillar in the reactor design stages, in order to achieve a homogeneous distribution of lighting with cost-effective.

The effect of carbon source on the internal organic composition of microalga Coelastrella sp. (MH923012), was addressed in the present study. Five to twenty-five milliliter, with increment 5 ml, of aqueous carbon source were dosing into two groups of cultivation flasks, unadjusted pH flasks group and adjusted pH flasks group. The results demonstrated that the improvement in the specific growth rate depends on how many dosing times of the carbonic solution added to the cultivation flasks. Furthermore, the balanced organic structure of the cell is affected by the amount of carbonate source available in the culture media. For instance, dosing of 25 ml of aqueous carbon dioxide solution has led to product 20.3% of lipids, 41.5% of proteins, and 30.1% of carbohydrates compared with that produce from the control flasks composition14.2 % of lipids, 27.7% of proteins, and 50.7% of carbohydrates. The experimental data also showed a significant increase in saturated and unsaturated fatty acids if the dosage were increased. In addition, adjusting the pH did not have a great effect on the rate of specific growth. However, the internal organic composition of microalgal cells has been affected by that adjustment. Therefore, the current study emphasizes the importance of adopting the carbon source as an important factor in the productivity and selectivity bioprocesses in microalgal cells.

Background: The coronavirus disease 2019 (COVID-19) pandemic has imposed enormous adversity worldwide. Public health guidelines have been a first line of defense but rely on compliance with evolving recommendations and restrictions. This study sought to characterize adherence to and perceptions of public health guidelines over a one-year timeframe during the pandemic. Methods: Participants were 1435 community adults in Ontario who completed up to five assessments (April 2020; July 2020; October 2020; January 2021; and April 2021; 92% retention). Participants were assessed for adherence to government protocols and perceptions of government response (importance, compliance, and effectiveness). Analyses used general linear mixed-effects regression modelling of overall changes by time and differences based on age, and sex. Findings: Over time, participants reported high or increasing engagement in public health guidelines, including physical distancing, restricting activity, and masking. In contrast, participants exhibited notable reductions in importance and compliance, with evidence of more negative changes in younger participants. Most dramatically, participants reported a substantial reduction in perceived government effectiveness, from predominantly positive perceptions to predominantly negative perceptions. Interpretation: These results illuminate evolving trends in public health compliance and perceptions over the course of the pandemic in Canada, revealing the malleability of public perceptions of public health recommendations and government effectiveness. Funding: This research was funded by a grant from the Canadian Institutes of Health Research (CIHR). Declaration of Interest: None to declare. Ethical Approval: The study’s procedures were reviewed and approved by the Hamilton Research Ethics Board (Protocol #4699).